Gastro hep advances最新文献

{"title":"Cover: Properties of Human Colonic Myenteric Neurons Differ Depending on Age, Disorder, and Colonic Region","authors":"","doi":"10.1016/j.gastha.2025.100616","DOIUrl":"10.1016/j.gastha.2025.100616","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100616"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anorectal Friction Force Is Reduced in Fecal Incontinence","authors":"Hans Gregersen , Bhavesh Patel , Xiaomei Guo , Giuliana Barron Del Solar , Samuel Eisenstein , Ghassan Kassab","doi":"10.1016/j.gastha.2024.10.020","DOIUrl":"10.1016/j.gastha.2024.10.020","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Integrin αvβ6 Antibody Titer as a Predictive Biomarker of Future Treatment Escalation in Patients With Ulcerative Colitis","authors":"Shuji Yamamoto, Takeshi Kuwada, Masahiro Shiokawa, Hiroki Kitamoto, Makoto Okabe, Hiroshi Seno","doi":"10.1016/j.gastha.2024.10.022","DOIUrl":"10.1016/j.gastha.2024.10.022","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-Wide DNA Methylation Markers Associated With Metabolic Liver Cancer","authors":"Samuel O. Antwi ,&nbsp;Ampem Darko Jnr. Siaw ,&nbsp;Sebastian M. Armasu ,&nbsp;Jacob A. Frank ,&nbsp;Irene K. Yan ,&nbsp;Fowsiyo Y. Ahmed ,&nbsp;Laura Izquierdo-Sanchez ,&nbsp;Loreto Boix ,&nbsp;Angela Rojas ,&nbsp;Jesus M. Banales ,&nbsp;Maria Reig ,&nbsp;Per Stål ,&nbsp;Manuel Romero Gómez ,&nbsp;Kirk J. Wangensteen ,&nbsp;Amit G. Singal ,&nbsp;Lewis R. Roberts ,&nbsp;Tushar Patel","doi":"10.1016/j.gastha.2025.100621","DOIUrl":"10.1016/j.gastha.2025.100621","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metabolic liver disease is the fastest-rising cause of hepatocellular carcinoma (HCC), but the underlying molecular processes that drive HCC development in the setting of metabolic perturbations are unclear. We investigated the role of aberrant DNA methylation in metabolic HCC development in a multicenter international study.</div></div><div><h3>Methods</h3><div>We used a case-control design, frequency-matched on age, sex, and study site. Genome-wide profiling of peripheral blood leukocyte DNA was performed using the 850k EPIC array. The study sample was split 80% and 20% for training and validation. Cell type proportions were estimated from the methylation data. Differential methylation analysis was performed adjusting for cell type, generating area under the receiver-operating characteristic curves (AUC-ROC).</div></div><div><h3>Results</h3><div>We enrolled 272 metabolic HCC patients and 316 control patients with metabolic liver disease from 6 sites. Fifty-five differentially methylated CpGs were identified; 33 hypermethylated and 22 hypomethylated in cases vs controls. The panel of 55 CpGs discriminated between the cases and controls with AUC = 0.79 (95% confidence interval [CI] = 0.71–0.87), sensitivity = 0.77 (95% CI = 0.66–0.89), and specificity = 0.74 (95% CI = 0.64–0.85). The 55-CpG classifier panel performed better than a base model that comprised age, sex, race, and diabetes mellitus (AUC = 0.65, 95% CI = 0.55–0.75; sensitivity = 0.62, 95% CI = 0.49–0.75; and specificity = 0.64, 95% CI = 0.52–0.75). A multifactorial model that combined the 55 CpGs with age, sex, race, and diabetes yielded AUC = 0.78 (95% CI = 0.70–0.86), sensitivity = 0.81 (95% CI = 0.71–0.92), and specificity = 0.67 (95% CI = 0.55–0.78).</div></div><div><h3>Conclusion</h3><div>A panel of 55 blood leukocyte DNA methylation markers differentiates patients with metabolic HCC from control patients with benign metabolic liver disease, with a slightly higher sensitivity when combined with demographic and clinical information.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100621"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Nutrition in the Management of Chronic Liver Disease","authors":"Matt Pelton ,&nbsp;Sarah Abdel-Meguid ,&nbsp;Eshani Goradia ,&nbsp;Arvind Bussetty ,&nbsp;Deborah Cohen ,&nbsp;Keerthana Kesavarapu","doi":"10.1016/j.gastha.2024.100613","DOIUrl":"10.1016/j.gastha.2024.100613","url":null,"abstract":"<div><div>Malnutrition is prevalent, detrimental, and associated with worse outcomes, including higher rates of hospitalization, morbidity, and mortality. In this review article, we aimed to define malnutrition in patients with chronic liver disease (CLD), elucidate the pathogenesis of malnutrition, discuss the advantages and disadvantages of current screening methods, and highlight the latest evidence-based dietary recommendations. Emerging evidence suggests that CLD-specific tools such as the Liver Disease Undernutrition Screening Tool and the Royal Free Hospital-Nutritional Prioritizing Tool can accurately identify patients at high risk for malnutrition and should be used in conjunction with more standard tools such as subjective global assessments. The pathogenesis of malnutrition in CLD is multifactorial but seems to arise in large from altered metabolism, namely a reduction in protein synthesis and an increase in resting energy expenditure. However, decreased nutrient intake, impaired nutrient absorption and increased nutrient losses have also been shown to contribute. Key findings in this review argue against protein-restricted diets in patients with CLD and support the use of plant-based proteins over dairy and meat proteins for those with liver cirrhosis complicated by hepatic encephalopathy. Frequent small meals are recommended in patients with liver cirrhosis in addition to the avoidance of prolonged fasts &gt;12 hours due to their hypercatabolic state. CLD covers a wide spectrum of diseases, and this review calls for an individualized approach to addressing the specific nutritional needs, depending on the etiology of CLD, its severity, associated complications, and comorbid conditions. This can be best achieved by close, longitudinal follow-up with a multidisciplinary team including a registered dietitian who can obtain a comprehensive, accurate nutritional assessment.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100613"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shotgun Metagenomics Reveals Bacteroides stercoris as a Fecal Biomarker Depleted in Late-Stage Hepatocellular Carcinoma","authors":"Damien Esparteiro ,&nbsp;Grégory Fouquet ,&nbsp;Anoïsia Courtois ,&nbsp;Mickaël Naassila ,&nbsp;Eric Nguyen-Khac ,&nbsp;Ingrid Marcq","doi":"10.1016/j.gastha.2024.07.020","DOIUrl":"10.1016/j.gastha.2024.07.020","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100539"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS Guided Enterocolostomy for the Palliation of Malignant Small Bowel Obstruction From a Cecal Adenocarcinoma","authors":"Brandon Rodgers,&nbsp;Abraham Mathew,&nbsp;Hadie Razjouyan","doi":"10.1016/j.gastha.2024.10.016","DOIUrl":"10.1016/j.gastha.2024.10.016","url":null,"abstract":"<div><div>Malignant bowel obstruction is a challenging complication in advanced gastrointestinal malignancies with varying treatment strategies including medical, surgical and endoscopic therapies, each with their own limitations. Endoscopic ultrasound–guided enterocolostomy has been previously reported as an option for patients who are not surgical candidates or ideal candidates for enteral stenting. In this case, endoscopic ultrasound–guided enterocolostomy is used for the palliation in a patient with a completely obstructing large cecal adenocarcinoma who declined surgical intervention.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100576"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessments of Health Utilities in Patients With Metabolic Dysfunction-Associated Steatohepatitis: Cross-Walk Between Disease-Specific Chronic Liver Disease Questionnaire, Short Form SF-6D, and EuroQol EQ-5D Instruments","authors":"Zobair M. Younossi ,&nbsp;Maria Stepanova ,&nbsp;Yestle Kim ,&nbsp;Stephen Dodge ,&nbsp;Dominic Labriola ,&nbsp;Rebecca Taub ,&nbsp;Fatema Nader","doi":"10.1016/j.gastha.2025.100642","DOIUrl":"10.1016/j.gastha.2025.100642","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The EuroQol-5D (EQ-5D) is a commonly used measure of health utilities to calculate quality-adjusted life years. For the clinical trials that use Chronic Liver Disease Questionnaire-nonalcoholic fatty liver disease (CLDQ-NAFLD) or Short Form-36 (SF-36), ability to convert the health-related quality of life scores (CLDQ-NAFLD or SF-36) to EQ-5D scores provides a valuable method to estimate health utility.</div></div><div><h3>Methods</h3><div>Baseline data of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) patients were used in this study. We used 2 cross-walk algorithms to estimate EQ-5D scores. The first algorithm used 6 domains of CLDQ-NAFLD in a fractional logistic model to yield EQ-5D estimates. The other algorithm included calculation of SF-6D utility scores from SF-36 items, which were fed into a regression model that estimated EQ-5D scores from SF-6D scores.</div></div><div><h3>Results</h3><div>There were 883 MASH patients with CLDQ-NAFLD and SF-36 data: 25% ≥65 years, 44% male, 80% obese (body mass index &gt;30), 67% type 2 diabetes, 62% F3 fibrosis, and 38% F1B/F2 fibrosis. The mean estimated EQ-5D scores were 0.851 (standard deviation = 0.146) according to CLDQ-NAFLD-based algorithm and 0.853 (standard deviation = 0.097) according to the SF-36-based algorithm. The correlations between the 2 estimated EQ-5D scores were up to +0.74. Similar to the total sample, the differences between the mean EQ-5D estimates using either calculation method did not exceed 0.012 in all studied subgroups (by age, sex, obesity, type 2 diabetes, and fibrosis stage).</div></div><div><h3>Conclusion</h3><div>Both cross-walk algorithms for the calculation of the EQ-5D utility scores in MASH patients were estimable with CLDQ-NAFLD or SF-36 instruments. A high positive correlation was seen between the total score and subgroup estimates using either method.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100642"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance Denial of Biologic Therapy is Associated With Reduced Remission Rates in Inflammatory Bowel Disease Patients","authors":"Erin Zisman ,&nbsp;Madeline Alizadeh ,&nbsp;Leah Rossmann ,&nbsp;Jennifer Grossman ,&nbsp;Cydney Nguyen ,&nbsp;Pinkle Paul ,&nbsp;Uni Wong","doi":"10.1016/j.gastha.2025.100647","DOIUrl":"10.1016/j.gastha.2025.100647","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Biologic therapy is indicated for patients with moderate to severe inflammatory bowel disease (IBD) and delays in access to these medications have been associated with higher health-care utilization. We examined whether patients who experienced insurance denials of biologics had worse outcomes, as indicated by disease activity and the number of emergency department (ED) visits and hospitalizations had following medication denial.</div></div><div><h3>Methods</h3><div>Our single-center retrospective cohort study included 169 patients with IBD who were seen at a tertiary care center (University of Maryland Medical Center) and had an insurance denial for biologic therapy between March 2021 and October 2021. Data were collected through chart review.</div></div><div><h3>Results</h3><div>At 6 months following denial, 58.0% of patients were in remission, 37.9% had active disease, and 4.1% had unknown status. Those who did not receive medication approval were significantly more likely to have active disease (Odds ratio = 0.16, 95% confidence interval = [0.04‒0.69] <em>P</em> = .042). Compared to patients in remission after delay in therapy initiation, those with active disease were likelier to receive steroids in the year following denial (38.5%, <em>P</em> &lt; .001), trended toward higher likelihood of ED visits (<em>P</em> = .062), and had higher likelihood of hospitalization in that time (27.7% vs 8.2%, <em>P</em> = .002), with a higher number of average ED visits (<em>P</em> = .019) and hospitalizations (<em>P</em> = .003). Patients with active disease post denial had a nearly 80% increase in days between denial and final approval (<em>P</em> = .031).</div></div><div><h3>Conclusion</h3><div>Our study demonstrates an association between insurance denial of biologic therapy and lack of clinical remission with associated increased health-care utilization in IBD patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100647"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Burden of Patients With Chronic Idiopathic Constipation in the USA Before and After Prucalopride Initiation","authors":"Paul Feuerstadt ,&nbsp;Mei Lu ,&nbsp;Emi Terasawa ,&nbsp;Brian Terreri ,&nbsp;Shawn Du ,&nbsp;Selina Pi ,&nbsp;Ben Westermeyer ,&nbsp;Rajeev Ayyagari ,&nbsp;Anthony Lembo ,&nbsp;Baharak Moshiree ,&nbsp;Mena Boules ,&nbsp;Brooks D. Cash","doi":"10.1016/j.gastha.2025.100664","DOIUrl":"10.1016/j.gastha.2025.100664","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Chronic idiopathic constipation (CIC) is associated with substantial health care resource utilization (HCRU) and economic burden; however, real-world evidence on the impact of treatment initiation on HCRU and health care costs are limited. We evaluated HCRU and direct health care costs associated with prucalopride initiation in patients with CIC in the United States.</div></div><div><h3>Methods</h3><div>Data were collected between January 1, 2015, and June 30, 2020, from the IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases for 690 adults with ≥ 1 prescription fill for prucalopride and ≥ 1 constipation-related diagnosis code. All-cause and constipation-related HCRU (outpatient, emergency room, and inpatient visits) for all patients, and pharmacy and medical health care costs for those aged 18–64 years were assessed 6 months before (baseline) and after (study period) prucalopride initiation. Subpopulations examined were patients with prior CIC medication use and males with CIC.</div></div><div><h3>Results</h3><div>Compared with baseline, the mean number of any constipation-related outpatient visits (2.26 vs 1.52; <em>P</em> &lt; .001) and the proportions of patients with these visits (82.6% vs 58.8%; <em>P</em> &lt; .001) significantly decreased after prucalopride initiation. In 564 patients, total constipation-related health care costs significantly increased from baseline during the study period (mean: $1497 vs $2332; <em>P</em> &lt; .001), primarily driven by increased pharmacy costs after prucalopride initiation ($621 vs $1751; <em>P</em> &lt; .001). Constipation-related medical costs significantly decreased during the study period ($876 vs $580; <em>P</em> &lt; .001). Some constipation-related HCRU and health care costs decreased after prucalopride initiation in patients with prior CIC medication use and males.</div></div><div><h3>Conclusion</h3><div>In adults with CIC, constipation-related HCRU and medical costs decreased, while constipation-related health care costs and pharmacy costs increased 6 months after prucalopride initiation.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 7","pages":"Article 100664"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}